A Canadian study finds that telemedicine between patients with diabetes and clinicians can help improve control of blood glucose levels.
Telemedicine, the use of telecommunications to deliver health services, includes text messaging and interactive websites (web portals). In this new study, researchers at the University of Alberta and the University of Calgary explored how effective this treatment strategy could be for diabetes management compared to standard care.
The study team evaluated 111 randomised controlled trials conducted in the United States, Canada, Australia, Korea and other countries.
The primary outcome of the trials was HbA1c, which was assessed at the beginning of all the studies and then monitored at three months, 4-12 months and after 12 months. Other outcomes included quality of life, mortality and episodes of hypoglycemia.
The communication included the use of telephones, smartphones, texting and Web portals, with interventions including medication and exercise.
Across the studies, which all compared telemedicine to standard care, two-way communication between patients and healthcare providers was found to improve blood sugar levels. However, “telemedicine had no convincing effect on quality of life, mortality or hypoglycemia”, the researchers noted.
Senior author Marcello Tonelli, University of Calgary, said: “Our systematic review showed that telemedicine may be a useful supplement to usual clinical care to control HbA1C, at least in the short term.
“Telemedicine interventions appeared to be most effective when they use a more interactive format, such as a Web portal or text messaging, to help patients with self-management.
“The use of SMS [short message service] text messaging may be feasible to communicate and motivate patients, which could result in positive outcomes.”
The findings appear online in CMAJ (Canadian Medical Association Journal).

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